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5-Aza-2'-deoxycitidine (decitabine, Dacogentrade mark, Bloomington, MN) is
a cytosine analogue that promotes hypomethylation of DNA and has documented
efficacy in myeloid malignancies. Indeed, promising clinical results have been
observed in acute myeloid leukemia (AML) and the myelodysplastic syndromes
(MDS). Aberrant methylation has also been found in chronic leukemias, providing
a rationale for investigating the use of decitabine in these diseases. There is
clear evidence of molecular (hypomethylation) as well as hematologic and
cytogenetic responses to decitabine in chronic myelogenous leukemia of all
phases, including in patients resistant to imatinib mesylate.
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